By Sophia Friedman and Anna Reilly
There has been a significant increase in both the number and severity of end stage renal disease (ESRD) and chronic kidney disease (CKD) cases in India over the past several decades. Of the estimated 1.3M individuals requiring access to dialysis services in India, only ~20% are receiving those services at the recommended frequency. This gap is primarily due to: 1) affordability as the average cost per session is price prohibitive to most; and, 2) supply side constraints given there is a significant gap in supply of dialysis machines, clinicians, and centers. Additionally, geographic location continues to serve as a barrier to access for individuals living in tier II or III cities versus tier I cities. While a number of private dialysis companies have been founded in India, few have been able to scale high-quality, affordable services across high-need areas. Similar challenges exist more broadly outside of India. In The Philippines and Uzbekistan, the number of individuals with kidney diseases continues to grow and the demand for services in these countries has far outpaced supply.
Solution
NephroPlus enables individuals suffering from kidney diseases to resume normal functioning of life through high-quality, cost effective dialysis treatments and services. NephroPlus is Asia’s largest chain of dialysis clinics with ~450 centers across 250+ towns in India, Uzbekistan, and The Philippines. The company offers services through both standalone centers and outsourced dialysis centers located in hospitals within tier I, II, and III cities, and through public-private partnerships. NephroPlus has an in-house dialysis staff training program, which both addresses supply side challenges and ensures high-quality delivery of services. During the last 10 years, more than 1,000 students have been trained and placed successfully at NephroPlus clinics. NephroPlus is well-positioned to serve the large and growing number of individuals with a need for high-quality, affordable dialysis services in India, The Philippines, Uzbekistan, and additional countries in Asia.
Why We Invested
The prevalence and severity of kidney disease cases continues to increase around the world, particularly across Southeast Asia. In India, The Philippines, and Uzbekistan, where NephroPlus operates, there is a significant supply-demand gap in terms of dialysis machines, centers, and clinicians required to care for individuals suffering from renal disease. To combat this discrepancy, the Indian government launched the Pradhan Mantri National Dialysis Programme, which partners with private providers to increase the number of centers, machines, and clinicians offering dialysis services in the country. The governments within The Philippines and Uzbekistan are also offering universal health coverage for these services through government partnerships. However, public programs alone will not be enough to overcome the gap in the number of needed machines. Further, these countries also struggle to properly recruit and train the number of nurses and technicians needed to provide care.
Given the need for machines, centers, and clinicians, NephroPlus is well-positioned to become a market leading provider of dialysis services across Asia. As a single specialty, multi-site provider of high-quality, cost effective dialysis services, NephroPlus will be capable of partnering with governments and outsourcing dialysis services for hospital and center partners. The NephroPlus founding team has extensive experience in the dialysis industry, including effectively scaling the company to ~450 centers since its foundation in 2010. Founder and CEO Vikram Vuppala founded NephroPlus with a clear objective to redefine and transform healthcare in India. Further, NephroPlus’s most significant investor, Quadria Capital, is committed to working together with the company to professionalize and optimize the business as NephroPlus continues to scale throughout Asia. The NephroPlus and Quadria Capital teams share a similar mission to build Asia’s largest network of dialysis centers offering high-quality, cost-effective services in countries with a significant need.
Impact
NephroPlus addresses all three barriers to services: accessibility, quality, and affordability. The company plans to add hundreds of additional centers across tier I, II, and III cities with the majority of centers added in tier III cities, where there is currently limited access to dialysis services. NephroPlus maintains a highly-qualified clinical board and ensures cohesive standard operating procedures lowering infection rates across centers and markets. Additionally, NephroPlus recently announced the publication of a research study in The Lancet Regional Health - Southeast Asia establishing the first national benchmark for survival amongst dialysis patients in India. The company has partnered with the governments in both The Philippines and Uzbekistan to ensure public coverage for services. Within India, while the company provides the majority of services through government models, either through PPP or offering services under government healthcare schemes, while the rest of services are either private insurance or self pay. NephroPlus intends to continue to partner with the Indian government to provide services through public-private partnership models.